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Moral injury — the quiet epidemic of soldiers haunted by what they did during wartime

On March 24, 2007, in a city just north of Baghdad, US Army infantryman Alex Horton shot a man twice in the abdomen. He saw the man stumble, then fall behind a building, out of sight. That’s all Horton knows, and all he will ever know, about what happened. He’ll never know if he was right to conclude, in that crucial split second, that the man was a threat to him and his fellow soldiers. But he thinks he was probably wrong. And that knowledge causes him lasting pain.

Horton's unit was on its 10th day in Baqubah, the capital of Iraq’s Diyala province, tasked with rooting out Sunni insurgents. They were out on patrol when a US Army Stryker traveling a few minutes ahead of Horton's ran over an IED. The explosion was so powerful that it knocked the vehicle on its side. Everyone in the Stryker was injured. One soldier’s leg was destroyed, shattered by the force of the blast.